Airway responsiveness to allergen is increased 24 hours after exercise challenge

Although exercise is one of the most ubiquitous triggers of acute bouts of asthma, the changes in airway responsiveness before and after exercise are not well defined. Specifically, the effect of the changes in airway responsiveness induced by exercise has not been studied on subsequent allergen exposure. To test whether the reactivity to allergen is altered by preceding exercise and to define possible factors determining it, we subjected 24 children with atopic asthma to the relevant allergen challenge on two occasions: one as a control without a preceding procedure and the other 24 hours after exercise challenge. Mean postallergen maximal percent falls in forced expiratory volume in 1 second from baseline (delta FEV1) of the whole group were higher after the exercise challenge compared with those of control in both early (< 1 hour) and late (3 to 10 hours) phases. The changes of postallergen maximal delta FEV1 between the control and post-exercise allergen challenges were not related to the early bronchial response to the preceding exercise challenge. Late asthmatic responses to exercise developed in six children, and the changes in both early and late phases were significantly higher in these children, compared with those without late asthmatic responses. Furthermore, the changes were well correlated with the magnitude of the late-phase response to preceding exercise in the group as a whole. It is concluded that an increased airway responsiveness to allergen occurs 24 hours after exercise in some patients with asthma. As the changes are related to a late bronchial response to exercise, late asthmatic response to exercise, when it occurs, may be associated with increased asthmatic symptoms for as long as 24 hours after exercise.